REPORTING PERIOD: January 2020

Complete the required data below. Only include data for this period and single site/program location as requested.
If you teach exercise and aquatic programs at one location, please complete a separate report for each program.

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* 1. Program Leader/Site Coordinator Full Name

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* 2. Your Email Address

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* 3. Facility Information

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* 5. Did you offer Arthritis Foundation classes during this reporting period?

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